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Physician compliance with pneumococcal conjugate vaccine shortage recommendations in 2004
Maureen S Kolasa1, Stephen M Tannenbaum, John M Stevenson
1Health Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333,USA. mkolasa@cdc.gov
Insights
During pneumococcal conjugate vaccine (PCV) shortages, healthcare providers quickly adjusted administration schedules based on new recommendations. Most children eventually received their delayed PCV doses, showing adaptability in immunization practices.
Area of Science:
- Pediatric infectious diseases
- Vaccine administration and policy
- Public health surveillance
Background:
- Pneumococcal conjugate vaccines (PCV) are critical for preventing invasive pneumococcal disease in children.
- Vaccine shortages and evolving recommendations can significantly impact immunization coverage rates.
- Understanding provider response to these changes is essential for maintaining public health goals.
Purpose of the Study:
- To evaluate the administration patterns of pneumococcal conjugate vaccine (PCV) during a period of vaccine shortage and altered recommendations in 2004.
- To compare PCV administration between healthy children and those identified as high-risk.
Main Methods:
- Retrospective analysis of PCV doses administered to children aged 3, 5, 7, and 16 months within a managed care health plan during 2004.
- Utilized ICD-9 codes to identify children categorized as high-risk.
- Assessed PCV dose coverage before, during, and after the shortage period and recommendation changes.
Main Results:
- PCV dose coverage for the initial two doses remained stable for both healthy and high-risk children.
- Significant decline in PCV3 coverage for healthy children during the shortage (63% to 7%), with recovery to pre-shortage levels post-recommendation.
- High-risk children exhibited similar PCV administration patterns to healthy children; most delayed PCV3 doses were administered after the shortage.
- PCV4 coverage mirrored the trends observed for PCV3.
Conclusions:
- Healthcare providers demonstrated prompt adaptation in PCV administration in response to shortage-related guidance.
- Minimal difference in coverage between healthy and high-risk groups suggests potential limitations in identifying high-risk status using ICD-9 codes.
- The study highlights the dynamic nature of vaccine delivery systems and the importance of clear, timely recommendations during public health challenges.
Objective:
To assess pattern of pneumococcal conjugate vaccine (PCV) administration during periods of vaccine shortage and changing recommendations.
Methods:
During 2004 PCV shortages, the Advisory Committee for Immunization Practices recommended delay of doses 3 and 4 (PCV3 and PCV4) to healthy children. A managed care health plan evaluated PCV doses administered to all enrolled children at ages 3, 5, 7, and 16 months in 2004; ICD9 codes were used to identify high-risk children.
Results:
Immunization coverage for the first two PCV doses remained relatively stable throughout 2004 for both high-risk and healthy children. PCV3 coverage for healthy children dropped significantly from 63 percent preshortage (February 2004) to a low of 7 percent (June 2004), then rose to preshortage levels of 2 months after recommendations were made to resume PCV3 administration. Coverage of high-risk children followed a similar pattern as that for healthy children. PCV4 coverage showed similar declines and increases following shortage-related recommendations as PCV3. Most children whose PCV3 dose may have been delayed during the shortage did receive PCV3 after the shortage.
Conclusions:
Providers demonstrated rapid change in PCV administration in response to shortage-related recommendations. Little coverage difference was seen between healthy and high-risk children, possibly due to inadequate ability to determine which children truly are at high risk identified on the basis of ICD9 codes.
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